Impact of inhaled corticosteroids on asthma hospitalization in Sweden

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Abstract
This paper has two purposes. The first is to examine whether increased medication of inhaled corticosteroids by asthmatic patients is correlated with an improvement in asthma control, measured as a reduction in asthma hospitalizations. The other purpose, if such a relationship can be established, is to analyse the economic consequences. Regional data on asthma hospitalization, i.e. number of bed-days, and sales of anti-asthmatic drugs from 14 regions in Sweden between 1978 and 1989 were used (covering 71% of the Swedish population). The data were analysed in multivariate pooled cross-section, time-series regressions. The variation in bed-days was explained by three variables: the sales of inhaled corticosteroids; total supply of in-patient care; and sales of inhaled bronchodilators, which were used as a proxy for asthma prevalence. The results indicate that sales of inhaled corticosteroids are significantly correlated with decreased hospitalizations for asthma. Assuming that the correlation also reflects a causal relationship, an increase in sales of inhaled corticosteroids by 1 defined daily dose (DDD) per day and 1000 inhabitants gave, on average over the study period, a reduction of 1.7 bed-days for asthma in in-patient care per 1000 inhabitants.